GIFT   OF 


■'i'j'fi 


AM  •••noBJAs 

vojg  pjo|A«o 


The  National  City  Company 

National  City  Bank  Building 
New  York 


Income  Tax  Record  Book 


COPYRIGHT,    1917,    BY   THE    NATIONAL   CITY    COMPANY 


Income  Tax  Record  Book 

and 
Synopsis  of  the 

Federal  Income  Tax  Law 

(Amended  September  8,  1916) 

As  Affecting  Individuals 


The  National  City  Company 

National  City  Bank  Building 
New  York 


A  National  Investment  Organization 

possessing  the  resources,  management 
and  distributing  facilities  which  make 
it  possible  to  offer  the  widest  range  of 
attractive  investment  bonds  which  we 
have  purchased  for  our  own  account. 


The  National  City  Company 

National  City  Bank  Building 
New  York 


Correspondent  Offices 


Philadelphia,  Pa. 

1421  Chestnut  Street 

Boston,  Mass. 

55  Congress  Street 

Pittsburgh,  Pa. 

Farmers  Bank  Building 

Cleveland,  Ohio.\  .      ,  ' ;  • 
Guardian  Building 

Detroit,  Mich. 

Dime  Bank  Building 

Buffalo,  N.Y. 

Marine  Bank  Building 

Kansas  City,  Mo. 
Republic  Building 

London,  England 
3  Lombeurd  Street 


Chicago,  111. 

137  So.  La  Salle  Street 

San  Francisco,  CeJ. 
424  California  Street 

Baltimore,  Md. 
Munsey  Building 

Washington,  D.  C. 

741  15th  Street,  N.W. 

Albany,  N.  Y. 
Douw  Building 

St.  Louis,  Mo. 

Bank  of  Commerce  Building 

Los  Angeles,  Cal. 
Hibernian  Building 

Wilkes-Barre,  Pa. 

Miners  Bank  Building 


INDEX 


Applies  to  Whom 9 

Amount  of  Normal  Tax 9 

Amount  of  Additional  or  Surtax 9 

Absence   16 

Accrued  Interest  on  Bonds i5 

Bonds  Exempt  from  the  Tax 10 

Bonds  Not  Exempt  from  the  Tax 10 

By  Whom  Tax  Deducted  from  Interest  on  Bonds 11 

Deducted  from  Interest  on  Bonds  at  the  Source 10 

Deducted  from  Foreign  Coupons  and  Interests 11 

Deductions  Allowed   12 

Executors    15 

Fiduciaries    15 

Foreign  Bonds  Not  Exempt 11 

Guardians    15 

Husband  and  Wife,  Exemption  of 15 

Head  of  Family 15 

Income,  Definition  of 14 

Income,  Exempt  from  the  Law 9 

Illness 16 

Municipal  Bonds  Exempt 10 

Notes  Not  Exempt 10 

Nonresidence   16 

Nonresident  Alien  9 

Payable  When 14 

Partnerships  15 

Public  Utility  Bonds  Not  Exempt 10 

Railroad  Bonds  Not  Exempt 10 

Return — Form    of    33 

Who  Must  File 14 

When  Filed 14 

Where  Filed  14 

When  Time  Extended  for  Filing 14 

Where  Forms  Secured 16 

Record  of  Bond  Coupons 20-22 

Record  of  Dividends 24 

Stocks,  When  Dividends  Exempt 10 

Tax  Payable  When 14 

Trustees 15 

United  States  Government  Bonds  Exempt 10 


34'J476 


Synopsis  of  the  Federal  Income  Tax 
as  Affecting  Individuals 


Applies  to  Whom 

The  Federal  Income  Tax  applies  to  every  individual,  a 
citizen  or  resident  of  the  United  States,  as  to  their  income 
received  from  every  source  within  and  without  the  United 
States,  and  non-resident  aliens  as  to  their  income  received 
from  sources  within  the  United  States. 

Amount  of  Normal  Income  Tax 

A  tax  of  two  per  centum  shall  be  levied  upon  the  entire 
net  income  of  citizens  or  residents  of  the  United  States  re- 
ceived in  the  preceding  calendar  year  from  all  sources,  in- 
cluding interest  on  bonds,  notes  or  other  interest-bearing 
obligations  of  residents,  corporate  or  otherwise. 

A  like  tax  of  two  per  centum  shall  be  levied  upon  the  en- 
tire net  income  received  in  the  preceding  calendar  year  from 
all  sources  in  the  United  States  upon  every  individual,  a  non- 
resident alien,  including  interest  on  bonds,  notes  and  other 
interest -bearing  obligations  of  residents,  corporate  or  other- 
wise. 

Amount  of  the  Additional  or  Surtax 

A  chart  showing  the  additional  or  surtax  on  incomes  from 
$5,000  to  $3,000,000  and  an  explanation  of  same  is  given  on 
pages  17,  18  and  19  of  this  book. 

Income  Exempt  from  the  Law 

The  proceeds  of  life  insurance  policies  paid  to  individual 
beneficiaries  upon  the  death  of  the  insured;  the  amount  re- 
ceived by  the  insured,  as  a  return  of  premium  or  premiums 
paid  by  him  under  life  insurance,  endowment,  or  annuity 
contracts,  either  during  the  terms  or  at  the  maturity  of  the 
term  mentioned  in  the  contract  or  upon  the  surrender  of  the 
contract ;  the  value  of  property  acquired  by  gift,  bequest,  de- 
vise or  descent  (but  the  income  from  such  property  shall  be 
included  as  income),  shall  be  exempt  from  the  provisions 
of  the  law. 


Bonds  Exempt  from  the  Tax 

All  bonds  of  the  United  States  Government,  any  state  or 
political  subdivision  thereof  (which  includes  city  bonds) 
or  its  possessions,  or  any  securities  issued  under  the  pro- 
visions of  the  Federal  Farm  Loan  Act  of  July  17,  1916,  are 
exempt  from  the  payment  of  the  Income  Tax. 

Bonds  Not  Exempt  from  the  Tax 

All  bonds  of  public  utility,  railroad  and  industrial  corpora- 
tions are  subject  to  the  normal  tax  of  two  per  cent.  All 
bonds  of  foreign  governments  and  foreign  cities  are  also 
subject  to  the  normal  tax  of  two  per  cent. 

Notes  Not  Exempt 

Notes  of  railroad,  public  utility  and  industrial  corpora- 
tions, like  bonds  of  such  corporations,  are  not  exempt  from 
the  tax.  However  a  promissory  note  not  exceeding  one  year 
in  time  is  not  subject  to  the  withholding  of  the  tax  at  the 
source  unless  the  amount  of  interest  during  the  year  exceeds 
$3,000. 

Stocks,  When  Dividends  Exempt 

"For  the  purpose  of  the  normal  income  tax  only  the  income 
embraced  in  a  personal  return  shall  be  credited  with  the 
amount  received  as  dividends  upon  the  stock  or  from  the 
net  earnings  of  any  corporation,  joint  stock  company  or  asso- 
ciation, trustee  or  insurance  company,  which  is  taxable  upon 
its  net  income."  In  other  words,  dividends  from  stock  of 
corporations  doing  business  in  the  United  States  shall  not  be 
subject  to  the  normal  tax,  but  to  the  additional  or  surtax. 

Deducted  from  Interest  on  Bonds  at  the  Source 

The  amount  of  the  normal  tax  shall  be  deducted  and  with- 
held from  fixed  or  determinable  annual  or  periodical  gains, 
profits  and  income  derived  from  interest  on  bonds  and  mort- 
gages or  deeds  of  trust  or  other  similar  obligations  of  cor- 
porations, joint  stock  companies,  associations  and  insurance 
companies,  whether  payable  annually  or  at  shorter  or  longer 
periods,  although  such  interest  does  not  amount  to  $3,000, 
subject  to  the  provisions  of  the  law,  requiring  the  tax  to  be 

10 


withheld  at  the  source  and  deducted  from  the  annual  income 
and  returned  and  paid  to  the  Government. 

Deducted  from  Foreign  Coupons  and  Interest 

The  normal  tax  shall  be  deducted  and  withheld  from  cou- 
pons, checks  or  bills  of  exchange  for  or  in  payment  of  inter- 
est upon  bonds  of  foreign  countries  (including  foreign  cities) 
and  upon  foreign  mortgages  or  like  obligations  (not  payable 
in  the  United  States)  and  also  from  coupons,  checks  or  bills 
of  exchange,  for  or  in  payment  of  any  dividends  upon  the 
stock  or  interest  upon  the  obligations  of  foreign  corpora- 
tions, associations  and  insurance  companies  engaged  in  busi- 
ness in  foreign  countries. 

By  Whom  Tax  Deducted  from  Interest  on  Bonds 

On  coupons  and  interest  paid  by  corporations  in  the 
United  States,  the  corporation  is  required  to  deduct  the  nor- 
mal tax  from  the  face  of  the  coupon  or  interest.  Where  a 
corporation  in  the  mortgage  securing  a  bond  or  by  other 
contract  has  agreed  to  pay  the  coupons  or  interest  in  full 
without  deducting  the  normal  tax,  it  is  necessary  for  the  cor- 
poration to  pay  the  Government  the  normal  tax  in  addition 
to  paying  the  holder  the  full  amount  of  the  coupon  or  inter- 
est. However,  the  individual,  when  making  his  return,  will 
show  the  normal  tax  paid  at  the  source  the  same  as  he  would 
if  it  had  been  deducted  from  the  face  of  the  coupon. 

It  is  the  practice  of  banks  paying  coupons  and  interest  to 
deduct  the  normal  tax  of  2%  from  the  face  of  all  coupons, 
unless  a  certificate  is  attached  by  the  owner  or  his  agent 
claiming  exemption,  except  U.  S.  Government  and  Munici- 
pal bonds,  which  are  exempt  under  the  law  from  the  tax  and 
consequently  no  certificate  claiming  exemption  need  be  at- 
tached. 

When,  however,  the  corporation  issuing  the  bond  pays  the 
normal  tax  and  has  so  agreed  with  the  bank  paying  the  cou- 
pons or  interest,  to  pay  the  amount  of  the  normal  tax,  then 
it  is  the  practice  of  the  banks  to  pay  the  coupons  in  full, 
whether  exemption  is  claimed  or  not. 

On  coupons,  checks  or  bills  of  exchange  for  and  in  pay- 
ment of  interest  upon  bonds  of  foreign  countries  (including 

11 


foreign  cities)  and  for  mortgages  or  like  obligations  (not 
payable  in  the  United  States)  or  in  payment  of  any  dividends 
upon  the  stock  or  interest  upon  the  obligations  of  foreign 
corporations  engaged  in  business  in  foreign  countries,  the 
Income  Law  provides  the  tax  in  such  cases  shall  be  withheld, 
deducted  and  returned  for  and  in  behalf  of  any  person  sub- 
ject to  the  tax  by : 

"(1)  any  banker  or  person  who  shall  sell  or  otherwise 
realize  coupons,  checks,  or  bills  of  exchange  drawn  or 
made  in  payment  of  any  such  interest  or  dividends  (not 
payable  in  the  United  States),  and 

(2)  any  person  who  shall  obtain  payment  (not  in  the 
United  States),  in  behalf  of  another  of  such  dividends 
and  interest  by  means  of  coupons,  checks,  or  bills  of 
exchange  and  also 

(3)  any  dealer  in  such  coupons  who  shall  purchase  the 
same  for  any  such  dividends  or  interest  (not  payable  in 
the  United  States),  otherwise  than  from  a  banker  or  an- 
other dealer  in  such  coupons." 

All  such  deductions  are  considered  under  the  law  as  hav- 
ing been  made  at  the  source. 

Deductions  Allowed 

In  computing  the  net  income  in  the  case  of  a  citizen  or 
resident  of  the  United  States,  for  the  purpose  of  the  tax, 
there  shall  be  allowed  as  deductions : 

"First.  The  necessary  expenses  actually  paid  in  car- 
rying on  any  business  or  trade,  not  including  personal, 
living,  or  family  expenses ; 

Second.  All  interest  paid  within  the  year  on  his  in- 
debtedness ; 

Third.  Taxes  paid  within  the  year  imposed  by  the 
authority  of  the  United  States,  or  its  Territories,  or  pos- 
sessions, or  any  foreign  country,  or  under  the  authority 
of  any  State,  county,  school  district,  or  municipality,  or 
other  taxing  subdivision  of  any  State,  not  including 
those  assessed  against  local  benefits ; 

Fourth.  Losses  actually  sustained  during  the  year,  in- 
curred in  his  business  or  trade,  or  arising  from  fires, 

12 


storms,  shipwreck,  or  other  casualty,  and  from  theft; 
when  such  losses  are  not  compensated  for  by  insurance 
or  otherwise:  PROVIDED,  That  for  the  purpose  of 
ascertaining  the  loss  sustained  from  the  sale  or  other 
disposition  of  property,  real,  personal  or  mixed,  acquired 
before  March  first,  nineteen  hundred  and  thirteen,  the 
fair  market  price  or  value  of  such  property  as  of  March 
first,  nineteen  hundred  and  thirteen,  shall  be  the  basis 
for  determining  the  amount  of  such  loss  sustained ; 

Fifth.  In  transactions  entered  into  for  profit,  but  not 
connected  with  his  business  or  trade,  the  losses  actually 
sustained  therein  during  the  year  to  an  amount  not  ex- 
ceeding the  profits  arising  therefrom; 

Sixth.  Debts  due  to  the  taxpayer  actually  ascertained 
to  be  worthless  and  charged  off  within  the  year ; 

Seventh.  A  reasonable  allowance  for  the  exhaustion, 
wear  and  tear  of  property  arising  out  of  its  use  or  em- 
ployment in  the  employment  in  the  business  or  trade ; 

Eighth,  (a)  In  the  case  ot  oil  and  gas  wells  a  reason- 
able allowance  for  actual  reduction  in  flow  and  produc- 
tion to  be  ascertained  not  by  the  flush  flow,  but  by  the 
settled  production  or  regular  flow;  (b)  in  the  case  of 
mines  a  reasonable  allowance  for  depletion  thereof  not 
to  exceed  the  market  value  in  the  mine  of  the  product 
thereof,  which  has  been  mined  and  sold  during  the  year 
for  which  the  return  and  computation  are  made,  such 
reasonable  allowance  to  be  made  in  the  case  of  both  (a) 
and  (b)  under  rules  and  regulations  to  be  prescribed  by 
the  Secretary  of  the  Treasury:  PROVIDED,  That  when 
the  allowances  authorized  in  (a)  and  (b)  shall  equal  the 
capital  originally  invested,  or  in  case  of  purchase  made 
prior  to  March  first,  nineteen  hundred  and  thirteen,  the 
fair  market  value  as  of  that  date,  no  further  allowance 
shall  be  made.  No  deduction  shall  be  allowed  for  any 
amount  paid  out  for  new  buildings,  permanent  improve- 
ments, or  betterments,  made  to  increase  the  value  of  any 
property  or  estate,  and  no  deduction  shall  be  made  for 
any  amount  of  expense  of  restoring  property  or  making 
good  the  exhaustion  thereof  for  which  an  allowance  is  or 
has  been  made." 

13 


Who  Must  File  Return 

Every  citizen  or  resident  of  the  United  States  having  a  net 
income  of  $3,000  or  more  for  the  taxable  year  is  required  to 
file  a  return,  although  all  or  a  part  of  said  income  may  be 
exempt  or  the  tax  may  have  been  deducted  at  the  source. 

When  Retum  to  be  Filed 

On  or  before  the  first  day  of  March,  1917,  and  on  the  first 
day  of  March  in  each  year  thereafter. 

Where  to  be  Filed 

The  return  shall  be  filed  with  the  Collector  of  Internal 
Revenue  for  the  district  in  which  the  person  making  the  re- 
tum has  his  residence  or  principal  place  of  business,  or,  if 
there  is  no  local  residence  or  place  of  business  in  the  United 
States,  then  with  the  Collector  of  Internal  Revenue  at  Balti- 
more, Maryland. 

Extension  of  Time  for  Filing 

The  Commissioner  of  Internal  Revenue  has  authority  to 
grant  a  reasonable  extension  of  time,  in  meritorious  cases, 
for  filing  returns  of  income  by  persons  residing  or  traveling 
abroad  who  are  required  to  make  and  file  returns  of  income 
and  who  are  unable  to  file  said  returns  on  or  before  March 
first  of  each  year. 

When  Tax  Payable 

All  assessments  shall  be  made  by  the  Commissioner  of 
Internal  Revenue  and  all  persons  shall  be  notified  of  the 
amount  for  which  they  are  respectively  liable  on  or  before 
the  first  day  of  June  of  each  successive  year,  and  said 
amounts  shall  be  paid  on  or  before  the  fifteenth  day  of  June. 

Income,  Definition  of 

The  net  income  of  a  taxable  person  shall  include  gains, 
profits,  and  income  derived  from  salaries,  wages,  or  compen- 
sation for  personal  service  of  whatever  kind  and  in  whatever 
form  paid,  or  from  professions,  vocations,  business,  trade, 
commerce,  or  sales,  or  dealings  in  property,  whether  real  or 
personal,  growing  out  of  the  ownership  or  use  of  or  interest 

14 


in  real  or  personal  property,  also  from  interest,  rent,  divi-^ 
dends,  securities,  or  the  transaction  of  any  business  carried 
on  for  gain  or  profit,  or  gains  or  profits  and  income  derived 
from  any  source  whatever:  PROVIDED,  That  the  term 
^'dividends"  as  used  in  this  title  shall  be  held  to  mean  any 
distribution  made  or  ordered  to  be  made  by  a  corporation, 
joint-stock  company,  association  or  insurance  company, 
out  of  its  earnings  or  profits  accrued  since  March  first, 
nineteen  hundred  and  thirteen,  and  payable  to  its  share- 
holders, whether  in  cash  or  in  stock  of  the  corporation, 
joint-stock  company,  association,  or  insurance  company, 
which  stock  dividend  shall  be  considered  income,  to  the 
amount  of  its  cash  value. 

Partnerships 

Persons  engaged  in  business  in  a  partnership  are  consid- 
ered only  in  their  individual  capacity.  The  share  of  the  prof- 
its of  a  partnership  to  which  the  partner  would  be  entitled,  if 
the  same  were  divided,  whether  divided  or  not,  is  to  be 
included  in  the  return  of  such  partner. 

Fiduciaries 

Guardians,  executors,  trustees  and  other  fiduciaries  are  re- 
quired to  file  a  return  of  the  income  of  estates  or  any  kind 
of  property  held  in  trust  by  them. 

Exemption  of  Husband  and  Wife,  Guardians  or  Trustees 

That  for  the  purpose  of  the  normal  tax  only  there  shall 
be  allowed  as  an  exemption  m  the  nature  of  a  deduction  from 
the  amount  of  the  net  income  of  each  of  said  persons,  ascer- 
tained as  provided  herein,  the  sum  of  $3,000  plus  $1,000  addi- 
tional if  the  person  making  the  return  be  a  head  of  a  family 
or  a  married  man  with  a  wife  living  with  him,  or  plus  the 
sum  of  $1,000  additional  if  the  person  making  the  return  be 
a  married  woman  with  a  husband  living  with  her ;  but  in  no 
event  shall  this  additional  exemption  of  $1,000  be  deducted 
by  both  a  husband  and  a  wife:  PROVIDED,  That  only  one 
deduction  of  $4,000  shall  be  made  from  the  aggregate  income 
of  both  husband  and  wife  when  living  together:  PRO- 
VIDED FURTHER,  That  guardians  or  trustees  shall  be 

15 


allowed  to  make  this  personal  exemption  as  to  income  de- 
rived from  the  property  of  which  such  guardian  or  trustee 
has  charge  in  favor  of  each  ward  or  cestui  que  trust. 

Absence,  Illness,  Nonresidence 

In  event  of  the  absence,  illness  or  the  nonresidence  of  the 
individual,  the  return  may  be  made  by  an  agent,  who  is  then 
responsible  for  the  correctness  of  the  return. 

Accrued  Interest  on  Bonds 

Accrued  interest  received  by  the  seller  of  a  bond  is  income 
and  the  purchaser  in  his  return  need  only  include  that  part  of 
the  interest  received  by  him  since  purchase. 

Forms 

All  the  necessary  forms  may  be  obtained  at  the  office  of 
the  Collector  of  Internal  Revenue  of  the  various  districts. 


16 


Explanation  of  Income  Chart 

The  chart  on  the  following  pages  illustrates  graphically 
the  rate  and  amount  of  tax  to  be  collected  under  the  new  law 
as  compared  with  the  tax  under  the  old  law  on  incomes  rang- 
ing from  $5,000  to  $3,000,000.  In  making  the  calculations  in 
each  instance  $4,000  has  been  deducted  from  the  total  income 
assumed  and  the  tax  payable  is  based  on  the  amount  re- 
maining after  making  this  deduction.  This  $4,000  is  the 
exemption  allowed  by  law  when  the  taxable  person  is  a  mar- 
ried man  living  with  his  wife,  a  married  woman  living  with 
her  husband,  or  a  person  the  head  of  a  family.  If  the  taxable 
person  is  unmarried  and  not  the  head  of  a  family  the  ex- 
emption is  but  $3,000. 

It  will  be  observed  that  unless  the  taxpayer's  net  income 
exceeds  $20,000,  in  which  event  if  married  his  taxable  in- 
come is  $16,000,  the  tax  is  only  2%.  If  the  income  of  $20,000 
is  capitalized  on  a  5%  basis  the  taxpayer's  income-producing 
property  will  have  a  value  of  $400,000.  His  income  tax,  how- 
ever, will  amount  to  only  $320  per  annum.  As  most  incomes 
are  derived  in  part  either  from  municipal  bonds  which  are 
tax  exempt,  or  from  dividends,  or  tax  free  bonds  of  Ameri- 
can corporations,  some  of  which  pay  the  normal  tax,  there- 
fore the  actual  tax  payable  by  the  individual  will  usually  be 
materially  less  than  the  amounts  indicated  in  the  calculations 
on  following  pages. 

Typical  Example 

Net  Income $100,000 

Normal  Tax  (2%  of  $96,000)      .      .     $1,920 

Surtax : 

1%  on  amount  by  which  $40,000 

exceeds  $20,000   (1%  on  $20,000)  200 

2%  on  amount  by  which  $60,000 

exceeds  $40,000   (2%  on  $20,000)  400 

3%  on  amount  by  which  $80,000 

exceeds  $60,000  (3%  on  $20,000)  600 

4%  on  amount  by  which  $100,000 

exceeds  $80,000  (4%  on  $20,000)  800 

Total $3,920 


17 


INCOME 

NORMAL 
TAX 

ai 

2% 

1% 

2% 

3% 

4% 

5% 

6% 

On  excess 

$20,000 

$40,000 

$60,000 

$80,000 

sioo.ooo 

$150,000 

$2 

Income 

of 

to 

to 

to 

to 

to 

to 

$4,000 

$40,000 

$60,000 

$80,000 

$100,000 

$150,000 

$200,000 

$2 

$5,000 

$20 

10,000 

120 

15,000 

220 

20,000 

320 

25.000 

420 

$50 

30.000 

520 

100 

35,000 

620 

150 

40,000 

720 

200 

45.000 

820 

200 

$100 

50,000 

920 

200 

200 

55,000 

1.020 

200 

300 

60.000 

1,120 

200 

400 

65.000 

1.220 

200 

400 

$150 

70.000 

1,320 

200 

400 

300 

75.000 

1,420 

200 

400 

450 

80,000 

1,520 

200 

400 

600 

85,000 

1.620 

200 

400 

600 

$200 

90.000 

1.720 

200 

400 

600 

400 

95.000 

1,820 

200 

400 

600 

600 

100,000 

1,920 

200 

400 

600 

800 

110,000 

2,120 

200 

400 

600 

800 

$500 

125,000 

2.420 

200 

400 

600 

800 

1,250 

135,000 

2,620 

200 

400 

600 

800 

1,750 

150,000 

2,920 

200 

400 

600 

800 

2,500 

175.000 

3,420 

200 

400 

600 

800 

2.500 

$1,500 

200.000 

3.920 

200 

400 

600 

800 

2.500 

3.000 

225.000 

4,420 

200 

400 

600 

800 

2,500 

3,000 

*. 

250,000 

4,920 

200 

400 

600 

800 

2.500 

3,000 

t 

275.000 

5.420 

200 

400 

600 

800 

2,500 

3.000 

« 

300.000 

5.920 

200 

400 

600 

800 

2,500 

3.000 

' 

350,000 

6,920 

200 

400 

600 

800 

2,500 

3,000 

• 

400,000 

7.920 

200 

400 

600 

800 

2,500 

3,000 

450,000 

8,920 

200 

400 

600 

800 

2,500 

3,000 

500,000 

9.920 

200 

400 

600 

800 

2,500 

3,000 

550,000 

10,920 

200 

400 

600 

800 

2,500 

3.000 

600.000 

11.920 

200 

400 

600 

800 

2,500 

3,000 

' 

650,000 

12,920 

200 

400 

600 

800 

2,500 

3.000 

700,000 

13,920 

200 

400 

600 

800 

2.500 

3.000 

, 

750.000 

14,920 

200 

400 

600 

800 

2.500 

3,000 

800,000 

15,920 

200 

400 

600 

800 

2,500 

3,000 

850,000 

16,920 

200 

400 

600 

800 

2,500 

3,000 

900.000 

17,920 

200 

400 

600 

800 

2,500 

3.000 

950.000 

18,920 

200 

400 

600 

800 

2,500 

3.000 

1.000,000 

19.920 

200 

400 

600 

800 

2.500 

3,000 

1,250,000 

24,920 

200 

400 

600 

800 

2.500 

3,000 

1,500.000 

29.920 

200 

400 

600 

800 

2.600 

3,000 

1.750  000 

34.920 

200 

400 

600 

800 

2.500 

3,000 

2.000,000 

39,920 

200 

400 

600 

800 

2,500 

3.000 

2.250,000 

44,920 

200 

400 

600 

800 

2,500 

3,000 

2.500,000 

49,920 

200 

400 

600 

800 

2,500 

3,000 

2.750,000 

54,920 

200 

400 

600 

800 

2.500 

3,000 

3.000,000 

59.920 

200 

400 

600 

800 

2.500 

3,000 

18 


AX    CHART 


TOTAL  TAX 

8% 

9% 

10% 

11% 

12% 

13% 

oo 

$250,000 

$300,000 

$500,000 

$1,000,000 

$1,500,000 

to 

to 

to 

to 

to 

Excess  of 

Under  new 

Under  old 

[)0 

$300,000 

$500,000 

$1,000,000 

$1,500,000 

$2,000,000 

$2,000,000 

law 

law 

$20 

$10 

120 

60 

220 

110 

320 

160 

470 

260 

620 

360 

770 

460 

920 

660 

1,120 

660 

1,320 

760 

1,520 
1,720 
1.970 
2,220 
2,470 

910 
1.060 
1.210 
1.360 
1.510 

2,720 

1.710 

3,020 

1,910 

3.320 

2.110 

3.620 

2.310 

3,920 

2,510 

4.620 

3,010 

6,670 

3,760 

6,370 

4,260 

7,420 

5,010 

9,420 

6,260 

11.420 

7,610 

13,670 

8,760 

15,920 

10,010 

$2,000 

18.420 

11,610 

4,000 

20,920 

13,010 

4,000 

$4,500 

26.420 

16,010 

4,000 

9,000 

31.920 

19,010 

4,000 

13,500 

37,420 

22,010 

4,000 

18,000 

42,920 

26,010 

4,000 

18,000 

$5,000 

48,920 

28,610 

4,000 

18,000 

10,000 

54,920 

32,010 

4,000 

18,000 

15,000 

00,920 

36.610 

4,000 

18,000 

20,000 

66,920 

39.010 

4,000 

18,000 

25,000 

72,920 

42.610 

4,000 

18,000 

30,000 

78.920 

46.010 

4,000 

18,000 

35,000 

84,920 

49.610 

4,000 

18,000 

40.000 

90,920 

63.010 

4,000 

18,000 

45.000 

96,920 

66.610 

4,000 

18,000 

50.000 

102,920 

60.010 

4,000 

18,000 

50.000 

$27,500 

135,420 

77.610 

4,000 

18,000 

50,000 

55,000 

167,920 

96.010 

4,000 

18,000 

50,000 

55,000 

$30,000 

202,920 

112.610 

4.000 

18,000 

50,000 

55,000 

60,000 

237.020 

130,010 

4,000 

18,000 

50,000 

55,000 

60,000 

$32,500 

276,420 

147.610 

4,000 

18,000 

50,000 

55,000 

60.000 

65,000 

312,920 

166,010 

4,000 

18,000 

50,000 

55,000 

60,000     1         97,500 

350,420 

182,510 

4,000 

18.000 

50,000 

55.000 

60,000     i      130.000 

387.920 

200.010 

19 


Record  of  Bond  Coupons 


DATB 


BONDS  FROM  WHICH  DETACHED 


MATURITY 


20 


Concerning  Exemptions,  Taxes  and  Amounts  Received 


EXEMPTION 
NOT  CLAIMED           . 

*                  EXEMPTION                                 TAX                   '                                AMOUNT 
CLAIMED                             DEDUCTED                                        CREDITED 

! 

• 

1 

_JIj , 

*— "■ "" f""" — 

i     1    i 

': 

! 

■ 

i 

I! 

1      ^ 

li 

1      i                         i 

'     i 

L^_    ■    _ 

!     i                       1 

.__   J 

li       i                  f.                   '        '                                        L 

1     [           ^1                       ^                     T 

i      ii 

1      1       1 

li 

nr  ^ 

1 

j 

il                i 

H-+-          -f- 

t 

.„ ,,. 

.!      1 \ _L 

,, 

1      1!    •            !       ^ 

;            j     11     1              1     ii                  L     I  ^ 

! 

1 

21 

' 

Record  of  Bond  Coupons 


DATE 

BONDS  FROM  WHICH  DETACHED                               ■         MATURITY 

~ — .^ 

J..,. 

'i                                                               ^ 

22 


Concerning  Exemptions,  Taxes  and  Amounts  Received 


EXEMPTION                                EXEMPTION                                  TAX                                                AMOUNT 
NOT  CLAIMED                                CLAIMED                              DEDUCTED                                    CREDITED 

1 

■  1 

1 

1 

1 

. 

j        j 

i 

,/ 

1 

i 

! 

i 

i 

, 

t 

i 

i 

i 

1 

' 

j 

J 

1 

• 

___ 

'\ 

. 

1 

1 

., ii 

i__: 

'i 

■ 

t" 

"ZT 


Record  of  Dividends  Received 


■                                               ':                                                                                                                                       1 

■if-     ■    ■    .                                                        ■                                                                  1 

DATE                        !                                           SBCUI^ITY                                                   i 

AMOUNT 

• 
• 

24 


Record  of  Dividends  Received 


DATE 


SECURITY 


AMOUNT 


j 

1.                                                                            .  "          ! 

i 

r 

-x — ^^ 

j 

1 

i 

i 

,  f. 

a 

! 

r~^- 

, . , ,                             i(.  „■,, ., 

L 

■                                                   r 

■i 

- 

f 

■ 

i 

r     ■ 

r 

h ''                      '                                                            L 

25 


Income  from  Miscellaneous  Sources 


DATE 

ITEMS                                                       1                           AMOUNT 

1 

! 

1 

.    ,            ,  .,  ...     ,         .,  ,     ,  „. 

"^ 


Deductions  Claimed 


DATE 


ITEMS 


AMOUNT 


' 

1 

- 

I 

i 

'    - 

i 

•' 

1 

— ■  --  - — --^™— »»_.-_— ^ 

— 1^_™™ 

■■ 

-~f— 

■ 

J 

T~- — 

i .. 

I 

•                 ■ 

\ 

I 

I 

y^'^' '"'' 

27 


Bonds  Owned  (exempt  from  Normal  Income  Tax) 

NAME  OF  BOND                         "STtS^                MATURITY             RATE                          TAX  ASSUMED  BY 

li                                                                        1                       1 

i                      !l          1 

!' 

•  !* 

1 

1 

1 

11 

1 

28 


Bonds  Owned  (Taxable) 

ft  n  ^ 


NAME  OF  BOND 


INTEREST 
DATES 


MATURITY 


RATE 


=^=^=^ 
sj 


AMOUNT  SUBJECT  TO  TAX 


!              il                                 i-                       ji 

li 

!! 

1      i 

I                    ■ 

1           i            ■ 

1                          '■ 

1           i        ^:                  i:            ;: 

29 


List  of  All  Holdings  and 


Bonds 

and 

Shares 


Name  of  Security 


Annual  Int.  Price  Purch'e 

Income       Pay'le  Paid  Date 


i               '           1 

r  n 

{         1 

» 

1 

1! 

1                             ■                  ■             ■ 

i 

''                                                               '         1 

" 

!                                                                      1 

1 
1 

II 

1 

'                                                                      " 

i 

1 

! 

i 

r 

1       . 

! 

i 

1 

:                    .          ,,                                            It — . 

30 


Total  Interest  Due  Each  Month 

Jan.  Feb.  Mar.  Apr.  May  June  July  Aug.  Sept.  Oct.  Nov.  Dec. 


31 


Memoranda 


i 

32  i 


TOBEnilfDINBYCOLIICTOR. 


Assessment  List  23-B .. 


Folio 


Line. 


Foriu  1040  (Revised  October,  1916). 


(bowing  district  and  date  received. 


INCOME  TAX. 

THE     PENAUTY 

FOR  FAILURE  TO  HAVE  THIS  RETURN  IN 
THE  HANDS  OF  THE  COLLECTOR  OF 
LNTERNAL  REVENUE  ON  OR  BEFORE 
MARCH  1  IS  $20  TO  $1,000. 

(see  instructions  on  PAOE  4.) 

UNITED  STATES  INTERNAL  REVENUE. 


TO  BE  FILLED  IN  BY  nrONAL  REVENUE  BOREM, 


File  No.  ... 
Audited  by 


IMPORTANT. 

Read  this  form  through  carefully. 

Fill  in  pages  2  and  3  before  making 
entries  on  first  page.  Write  legibly, 
using  typewriter  if  possible. 


RETURN  OF  ANNUAL  NET  INCOME  OF  INDIVIDUALS, 

(As  provided  by  Act  of  Congress  approved  September  8,  X9I6.) 


FOR   YEAR   1916. 


Filed  by  (or  for) 


.,  of, 


(Street  and  number.) 


("post-office  address.)                                                                                                                     (State.) 

Mi 

$ 

ioo. 

1 

H 

0»i. 

2    (trvprat.  DnnTTmnMS  fhrmitrlit  frnm  Iitia  40^                                                                                    .       .    . 

1 

1 

$-.. 

:i: 

...1... 

Dividends  and  personal  exemption  to  be  deducted  in  computing  income  subject  to  normal  tax. 

Mil 
$-- 

$- 

lion 

... 

Tl. 

- 

... 

H 

... 

C»u 

5.  Personal  exemption  (single,  $3,000;  married  or  head  of  family,  $4,000). 

.  6.  Total  dividends  and  personal  exemption  (Items  4  and  5 

$ 

1 

1 

8.  Amount  of  Normal  Tax  at  rate  of  2  per  cent  on  income  shown  on  line  7 

9,  Ceedit  by  amount  of  normal  tax  paid  or  to  be  paid  at  source  (1  per  cent  of 

on  line  25,  Column  A)                                                      „ 

$.- 

... 

... 

amount  of  income  shown 

10.  Balanck  of  normal  tax  due _ 

$... 

KOTE. — When  the  net  income  shown  above  on  line  3  exceeds  $20,000  the  additional  tax  thereon  must  be  calculated  as  per  schedule  below. 


Income. 

Tax. 

One  per  cent  on  amount  over  $20,000  and  not  exceeding  $40,0P0        ..  .. 

Mi 
$- 
$ 

liM 

... 

Th 

"" 

Dda 

^ 

mOr 

•d> 

C.U 

Mi 

lio. 

Th 

"** 

H 

jodr 

•d< 

Cu 

... 

... 

... 

... 

... 

... 

Three  per  cent  on  amount  over  $60,000  and  not  exceeding  $80,000 

Four  per  cent  on  amount  over  $80,000  and  not  exceeding  $100,000  „.,..... 

Five  per  cent  on  amount  over  $100,000  and  not  exceeding  $150,000  

Six  per  cent  on  amoimt  over  $150,000  and  not  exceeding  $200,000 

Seven  per  cent  on  amount  over  $200,000  and  not  exceeding  $250,000 

Eight  per  cent  on  amount  over  $250,000  and  not  exceeding  $300,000  

Nine  par  cent  on  amount  over  $300,000  and  not  exceeding  $500,000 

Ten  per  cent  on  amount  over  $500,000  and  not  exceeding  $1,000,000  

Eleven  per  cent  on  amount  over  $1,000,000  and  not  exceeding  $1,500,000... 
Twelve  per  cent  on  amount  over  $1,500,000  and  not  exceeding  $2,000,000... 
Thirteen  per  cent  on  amount  over  $2,000,000 

$- 
$ 

... 

... 

... 

... 

... 

... 



$-- 

_. 

... 

... 

._ 

... 

- 

- 

$... 

$-. 

... 

... 

_ 

- 

... 



$ 

$... 
$.-- 

? 

... 

... 

... 

... 

... 

... 

... 

... 

- 

... 

... 

... 

... 

... 



U    Total  additional  tax                                                                        

12.  Balance  of  normal  tax  due,  as  shown  on  line  10 

$ 

13.  Total  Tax  Due ■. 

$.. 

... 

... 

... 



33 


GROSS  INCOME. 

This  sutement  must  show  in  the  proper  spaces  the  ENTIRE  AMOUNT  of  gains,  profits,  and  income  from  all  sources  received 
during  the  year  speoified  on  page  1,  EXCEPT  interest  received  from  the  obligations  of  the  United  States  or  any  of  its  possessions,  or 
of  any  State  or  political  subdivision  thereof,  including  district  drainage  bonds;  from  securities  issued  tmder  the  provisions  of  the 
Federal  Farm  Loan  Act  of  July  17,  1916;  and  amounts  paid  by  a  State  or  any  political  subdivision  thereof  for  services  rendered  as  an 
oflBcer  or  employee. 

DESCRIPTION  OF  INCOME. 

NOTE.— Tf  bu«1»nd  .nd  wH«  n-nder  Mptrat.  retu™,  only  the  iaoome  and  d«3aetlon.  of  the  hu.- 
fcend  or  wU«  (u  the  cuo  may  be)  who  rende™  thi.  return  shsll  ba  inelud-d  herein:  but  if  sepaf«t« 
ntuTMsrenot  rendered  by  both  husband  mnd  wife  theinoomo»nd  deduotion»  of  both  husband  and 
wife  shall  be  included  separately  as  provided  on  this  form. 

A. 

Income  on  which  the  tax  has  been 
paid  or  is  to  be  paid  at  the  source, 
at  the  rate  of  1  per  cent.    (See 
Note  2. ) 

Income  on  which  the  tax  has  NOT 
been  paid  or  is  not  to  be  paid  at 
the  source.    (See  Note  2.) 

Total  Amount  Derived  from— 

14.  Salaries,  wages,  and  conunissions : — : 

Wife's  income                                                                       

Uil 

lOD 

The 

<!• 

Hu. 

•died. 

Cents 

U.1 

1- 

ieni 

Tb, 

<K 

Ho. 

wlr. 

d. 

U.LI 

Wife's  income 



16.  Business,  trade,  commerce,  or  sales,  or  dealings  in  property,  whether 

Wife's  income                                                            - .. 

Wife's  income  . 

18.  Interest  on  notes,  mortgages,  bank  deposits,  and  from  all  other 

....... 

... 

... 

... 

... 

... 

... 





... 

... 

... 

... 

... 



19.  Interest  on  bonds,  mortgages,  or  deeds  of  trust,  or  other  similar  obh- 
gations  of  domestic  corporations,  joint-stock  companies  or  associa- 

20.  Fiduciaries*  (excepting  dividends  from  domestic  corporations,  which 
xniipt  be  entTe'l  on  liT^e  "0  bplnw) 

... 

Wife's  income >. 

21.  Partnershin  gains  and  profits,  whether  distributed  or  not  (excepting 
dividends  from  domestic  corporations,  which  must  be  entered  on 
line  28  below^.    (Net  gains  or  profits  must  be  reported  here  and  in 

- 

Wife's  income 

Note.— Give  name  and  full  address  ol  partnersliip-of  wlilch  you  arc  a  member. 

22.  Interest  upon  bonds,  etc.,  issued  in  foreign  coimtries,  and  dividends 
upon  the  stock  of  foreign  corporations,  etc.,  engaged  in  business  in 
foreign  countries 

... 

Wife's  income  ■ 



... 

... 

... 

... 

£3.  Boyalties  from  mines,  oil  wells,  patents,  franchises,  or  other  legalized 

-- 

... 

... 

... 

... 

Wife's  income                                             ~       -  

Note.— State  here  sources  from  wliicli  income  entered  on  line  24  is  received  and  amount 
received  from  each. 

25.  Totals  (Note. — Enter  1  per  cent  of  total  amovmt  of  Column  A  on 

$.- 

«... 

26.  Aggregate  Totals  of  Columns  A  and  B 

I- 

1 

27.  Dividends  on  stock  of  corporations,  etc.,  subject  to  like  tax 

f 

28.  Dividends  received  through  partnership.    (See  line  21) 

..... 

... 

... 

... 

... 

... 

.... 

29.  Dividends  received  through  fiduciaries.    (See  line  20) w„ 

Wife's  income 

... 

... 

... 

... 

... 

.... 



80                          TriTAT.  DrvrnnNna.     (Linps  27,  28,  and  29  )     (Fnter  on  line  4) 

81.                     Total  Gross  Income  (to  be  entered  on  line  1) 

$... 



♦  There  should  be  Included  under  this  Item  all  income  received  from  guardians,  trustees,  executors,  administrators,  receivers,  conservators,  or  other  persons  acting 
In  a  fidi;ciary  camclty , 

Note  1  .—If  incomB  derived  from  sale  of  property  acquired  before  March  1, 1913,  is  returned  above,  attach  a  statement  showing  (o)  fair  market  price  or  value  as  ol 
March  1,  1913,  (6)  price  at  which  property  was  sold,  and  U)  how  fair  market  price  or  value  as  of  March  1, 1913,  was  determined.                              ...          „      ^ 

Note  2.— Enter  In  column  A  only  the  income  on  which  the  normal  tax  has  been  or  is  to  be  paid  at  the  source.    Other  income  should  be  entered  in  column  D.     For 
example:  A  salary  of  «io.()00  is  rcreived  and  personal  exemption  of  $4,000  claimed.    Enter  In  column  A  16,000  (ttie  amount  Of  Income  on  which  the  normal  tax  was  witl»- 
hold)  and  in  column  U  H.OUO  (t^ie  amount  of  salary  on  which  no  tax  was  withheld).                                                                                                            •  •i—tni 

34 


GENERAL  DEDUCTIONS. 
NOTE.— Claims  for  deductions  may  not  be  allowed  unless  the  information  required  below  is  clearly  set  forth. 

32.  The  amount  of  necessary  expenses  actually  paid  within  the  calendar  year  for  which  the  return  is  made, 
in  carr  j-in^  on  any  individual  business.    (There  must  not  be  included  under  this  head  personal, 
living,  or  family  expenses,  business  expenses  of  partnerships,  or  cost  of  merchandise.     Amounts- 
paid  for  permanent  improvement  or  betterment  of  property  are  not  proper  expense  deductions).*,. 

Mil 

Uom 

Th 

Ids 

H 

mdn 

da 

... 

-- 

._ 

33,  All  interest  paid  within  the  year  on  personal  indebtedness  of  taxpayer 

Wifp'a  f1iv?,,r.tinTl                                                                                         _. 

, 

~ 

84.  All  national,  foreign,  State,  county,  school,  and  municipal  taxes  ortaxes  imposed  by  other  taxpaying 



Wiffi'nd<»Hiirtir>n ,, .  -.- 

... 

... 

... 

... 

... 

... 

35.  Losses  actually  sustained  during  the  year,  incurred  in  my  business  or  trade,  or  arising  from  fires, 
storms,  shipwreck,  or  other  casualty,  and  from  theft,  not  compensated  for  by  insurance  or  other- 

WisA    ,     .                '                       , ,                     

Wiffi'n  Hpdiirtjnn 

Note. — State  (a)  of  what  the  loss  consisted,  (6)  when  it  was  actually  sustained,  (c)  how  it 
was  determined  to  be  a  loss,  and  (d)  if  sustained  by  sale  of  property  acquired  before  Marchl, 
1913,  the  fair  market  price  or  value  as  of  that  date  and  how  such  value  was  determined. 

86.  Losses  sustained  during  the  year  in  transactions  entered  into  for  profit  but  not  connected  with  my 
business  or  trade.    (No  amount  in  excess  of  aggregate  income  from  these  sources  is  allowable) 

Wiffi'H  Hpdiirtinn                              , 

... 

... 

... 

~- 

"- 

... 



Note.— State  toul  income  during  the  year  from  such  tranaactionB (I ). 

Give  the  same  information  called  for  in  note  under  linp  35. 

87.  Debta  past  due  wbt'nh  have  been  actually  ascertained  to  be  worthless  and  which  have  been  chained 

Wiff'f  dfd'irtion             . ... ., ... 

... 

... 

... 

- 



Note.— State  (a)  oi  what  the  debts  consisted,  (6)  when  they  were  created,  (c)  when  they 
became  due,  (d)  how  they  were  actually  determined  to  be  wortnleas,  and  («)  whether  included 
as  income  in  tms  or  previous  return. 

88.  Amount  representing  a  reasonable  allowance  for  the  exhaustion,  wear,  and  tear  of  property  arising 
out  of  its  use  or  employment  in  business  or  trade.    (No  deduction  is  allowable  for  any  amoimt  ol 
expense  of  restoring  property  or  making  good  the  exhaustion  thereof  for  which  an  allowance  is 
made  in  this  return,  or  for  depreciation  of  residential  property  not  maintained  for  rental.    In  the' 
Cfl-ip  of  hnJldinf'a  dpprfirirvtion  ifl  tt^  he  cmipiitfid  exclupive  01  COflt  "f  Inid)              ,,  ,, , 

Wife'oHpHiiPtinn              ,..., ,.. 

Note.— State  (a)  the  kind  of  property  on  which  depreciation  is  taken  (if  buildings,  state  when 
erected  and  of  what  material  constructed),  (6)  coat  of  same,  and  (c)  what  percentage  of  deprecia- 
tion is  claimed. 

89.  Amount  representing  a  reasonable  allowance  for  depletion  (a)  in  the  case  of  oil  and  gas  wells  for 
actual  red  uctiou  in  flow  and  production,  and  (6)  in  the  case  of  mines  not  exceeding  the  market  value  ' 

Wjfp'p  d<H\irtion 

Note.— The  depletion  allowable  shall  be  at  a  rate  which  during  the  estimated  life  of  the 
property  being  depleted  will  return: 

The  cost  of  the  property,  if  acquired  after  March  1,  1913,  or 

The/air  market  value  as  of  March  1, 1913,  if  acquired  before  that  date. 

State  (a)  the  cost  of  property  if  purchased  after  March  1, 1913,  (6)  the  fair  market  value  as  of 
March  1,  1913,  if  piu-chased  prior  to  that  date,  (c)  how  such  value  was  determined,  and  (d)  the 
basis  upon  which  the  amount  of  depletion  claimed  is  computed. 

$_ 

_ 

40.                      TOTAL  "GENERAL  DEDUCTIONS"  (to  be  entered  on  line  2) 

NOTE.-II  space  la  Insufficient  tor  answering  any  questum,  attacb  a  supplemaiUal  sheet  to  this  return.                         •  t-«Ti 

35 


COMPLETE  ANSWERS  SHOULD  BE  GIVEN  TO  THE  FOLLOWING  QUESTIONS. 

If  you  rendered  return  for  precedirig  year,  state  district  in  which  filed . 

If  your  husbsmd  or  wife  made  separate  return  for  this  year,  state  district  in  which  filed 


Were  you  the  head  of  family,  single,' or  married  with  wife  or  husband  living  with  you  on  December  31  of  the  year  for  which  this  return 

is  rendered? 

If  married,  give  full  name  of  wife  or  husband . 

If  head  of  family,  give  relationship  of  those  dependent  upon  you ^ 

Has  your  wife  or  husband  income  from  Bourcea  independent  of  your  own? If  so,  has  same  been  included  ia  this  return? 

State  yoiur  profession,  vocation,  or  principal  business  from  which  your  income  is  derived 

AFFIDAVIT  TO  BE  EXECUTED  BY  INDIVIDUAL  MAKING  HIS  OWN  RETURN. 

I  swear  (or  affirm)  that  the  foregoing  return,  to  the  best  of  my  knowledge  and  belief,  contains  a  true  and  complete  e[tatement  of  all 
taxable  gains,  profits,  and  income  received  by  me  during  the  year  for  which  the  return  is  made,  and  that  I  am  entitled  to  all  ti^e  deduc- 
tions and  exemptions  entered  or  claimed  therein  under  the  Federal  Income  Tax  Law  of  September  8,  1916. 


Sworn  to  and  subscribed  before  me  this.; day  of ,. 


(Signature  or  individual.) 
191 


[seal] 


(Official  capacity.) 


AFFIDAVIT  TO  BE  EXECUTED  BY  DULY  AUTHORIZED  AGENT  MAKING  RETURN  FOR  INDIVIDUAL. 

I  swear  (or  affirm)  that  I  have  sufficient  knowledge  of  the  affairs  and  property  of 

to  enable  me  to  make  a  full  and  complete  return  of  his  taxable  income  ana  that  the  foregoing  return,  to  the  best  of  my  knowledge  and 
belief,  contains  a  true  and  complete  statement  of  all  the  taxable  ^na,  profits,  and  income  received  by  said  individual  during  the  year 
for  which  the  return  is  made,  and  that  the  said  individual  is  entitled  under  the  Federal  Income  Tax  Law  of  September  8,  1916,  to  all 
the  deductions  and  exemptions  entered  cr  claimed  therein,  and  that  I  am  authorized  to  make  this  return  for  the  following  reasons: 


(Signature  ol  acent.) 


Sworn  to  and  subscribed  before  me  this. 


jday  of- 


(Post-office  address  ol  agent.) 

.  101 


[seal] 


(Official  capacity.) 


INSTRUCTIONS. 


1.  This  return  shall  be  made  by  every  citizen  of  the  United 
States,  whether  residing  at  home  or  abroad,  and  by  every  person 
residing  in  the  United  States,  though  not  a  citizen  thereof, 
having  a  net  income  of  $3,000  or  over,  including  dividends,  for 
the  taxable  year,  although  the  tax  has  been  paid  at  the  source 
and  the  return  snows  no  tax  liability. 

2.  This  return  shall  be  made  by  every  nonresident  alien  receiv- 
ing any  net  income  from  sources  in  the  United  States.  A  non- 
resident alien  individual  may  receive  the  benefit  of  the  personal 
exemption  only  by  filing  or  causing  to  be  filed  with  the  Collector 
of  Internal  Revenue  a  true  and  accurate  return  of  his  total 
income,  received  from  all  sources,  corporate  or  otherwise,  in 
the  United  States. 

3.  When  an  individual  by  reason  of  minority,  sickness,  or 
other  disability,  or  absence  from  tho  United  States,  is  unable 
to  make  his  own  return,  it  may  be  made  for  him  by  his  duly 
authorized  representative. 

•4.  This  return  should  be  filed  with  the  Collector  of  Internal 
Revenue  for  the  district  in  which  the  individual  resides.  In 
case  the  person  resides  in  a  foreign  country,  then  with  the  Col- 
lector for  the  district  in  which  his  principal  business  is  carried 
on  in  the  United  States,  aud  if  there  be  no  such  place  in  the 
United  States,  then  with  the  Collector  of  Internal  Revenue  at 
Baltimore,  Maryland. 


5.  When  the  return  is  not  filed  within  the.  required  time 
by  reason  of  sickness  or  absence  of  the  individual,  an  extension 
of  time,  not  exceeding  30  days  from  March  1,  within  which  to 
file  such  return  may  be  granted  by  the  Collector,  provided, 
a  written  application  therefor  is  made  by  the  individual  within 
the  period  for  which  such  extension  is  desired. 

6.  An  unmarried  individual  or  married  individual  not  living 
with  husband  or  wife  shall  be  allowed  an  exemption  of  $3,000. 
When  husband  and  wife  livo  together  they  shall  be  allowed 
jointly  a  total  exemption  of  only  $4,000  on  their  aggregate  in- 
come. The  head  of  a  family  shall  be  allowed  an  exemption 
of  $4,000.  Guardians  or  trustees  shall  be  allowed  an  exemption 
of  $3,(X)0  in  favor  of  each  ward,  but  in  no  event  shall  a  ward  be 
allowed  a  greater  personal  exemption  than  $3,000  or,  if  married, 
$4,000,  from  the  amount  of  net  income  received  from  all  sources. 
There  shall  be  allowed  an  exemption  of  $3,000  from  the  amount 
of  the  net  income  of  estates  of  deceased  persons  during  the  period 
of  administration  or  settlement,  and  of  trusts  or  other  estates  the 
income  of  which  is  not  distributed  annually. 

7.  Amounts  charged  on  line  32  for  restoring  property  or  making 
good  the  exhaustion  thereof  from  its  use  in  business,  together 
with  the  amount  claimed  for  depreciation  on  line  38,  must  not 
exceed  ^e  deterioration  of  the  property  in  one  year.       •  »-tni 


36 


THIS  BOOK  IS  DUE  ON  THE  LAST  DATE 
STAMPED  BELOW 

AN  INITIAL  FINE  OF  25  CENTS 

WILL  BE  ASSESSED   FOR   FAILURE  TO   RO^JRN 
THis   BOOK   ON   THE  DATE  DUE.   THE  PENALTY 

w ,  L  Increase  to  so  cents  on  the  fourth 

pIvTnD    TO    Joo    ON    THE    SEVENTH     DAY 
OVERDUE.  ^^____— 


-«t-2^-m7 


&v-.ai 


58M 


jrec:dJ=^- 


LD21-100w-12,'43  (8796s) 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 


